White House Budget Falls Short on Global HIV & TB

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Although some details are still murky, a first-blush analysis of  Obama Administration’s fiscal year 2011 budget doesn’t look good for US efforts to combat the HIV and tuberculosis epidemics. From treatment to prevention, these global health threats could get short-changed under the White House plan.

Let’s start with PEPFAR, the President’s Emergency Plan for AIDS Relief. For the second year in a row, the Administration has called for a single-digit increase for this program, about 2.6 percent, or $141 million. That small increase comes despite lofty campaign promises, congressional mandates, plus a pledge that PEPFAR would serve as the “cornerstone” of the Administration’s new Global Health Initiative (more on the GHI later).

The White House’s PEPFAR budget is not adequate to preserve vital momentum in HIV treatment scale-up, nor is it enough to fund important new HIV prevention innovations in the developing world.

The numbers for TB are even more disheartening. The Administration only requested a $5 million increase over 2010 funding, a paltry amount for a disease that last year killed more than 1.8 million people, including 500,000 women. Moreover, the Centers for Disease Control’s TB program, with its critical clinical trials network, would be cut by more than $1 million, further undermining US capacity to evaluate new diagnostic, treatment and prevention tools for TB. This comes in the face of evidence that drug-resistant TB is a growing threat and if left unchecked, could spiral into a broader global health catastrophe.

Here’s a more detailed analysis of all global health funding from the Global Health Council:  GHC FY11 CBJ GH Funding Chart (Draft). The Kaiser Family Foundation also has this helpful breakdown. The Global Center, the GHC, and other groups will continue to analyze the budget as more details come out.

One bright spot in the Administration’s request was in biomedical research at the National Institutes of Health, which would see a $1 billion boost under today’s plan, including $98 million for HIV/AIDS research at NIH, a significant increase at a time of constrained resources.

There’s no question the U.S. faces tough choices amid spiraling deficits and a difficult economy, but underfunding much needed global health programs, which account for a fraction of the federal budget, is not the answer to America’s fiscal woes. Investment in these programs will reap immense dividends down the line–in financial, diplomatic, and public health arenas alike.

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